Provider Demographics
NPI:1417528761
Name:JESSICA S BROWN DMD LLC
Entity Type:Organization
Organization Name:JESSICA S BROWN DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:229-924-4479
Mailing Address - Street 1:1108 FETNER DR
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3774
Mailing Address - Country:US
Mailing Address - Phone:229-924-4479
Mailing Address - Fax:229-924-4391
Practice Address - Street 1:1108 FETNER DR
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3774
Practice Address - Country:US
Practice Address - Phone:229-924-4479
Practice Address - Fax:229-924-4391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental